Hepatic manifestations in typhoid fever

Area of Science:

• Pediatric Infectious Diseases
• Hepatology
• Microbiology

Background:

• Typhoid fever, caused by *Salmonella Typhi*, remains a significant global health concern.
• Multidrug resistance in *S. Typhi* complicates treatment and may influence disease manifestations.
• Hepatic involvement in pediatric typhoid fever is recognized but requires detailed characterization.

Purpose of the Study:

• To prospectively evaluate hepatic function in children with multidrug-resistant typhoid fever.
• To assess the prevalence and nature of hepatic manifestations during hospitalization.
• To determine the reversibility of hepatic dysfunction after antibiotic therapy.

Main Methods:

• Prospective study of 31 children (2 months to 12 years) with blood culture-confirmed multidrug-resistant *S. Typhi*.
• Assessment of liver function tests, including SGOT, SGPT, AP, SB, SA, and PT at admission and 2-3 weeks post-treatment.
• Clinical examination for hepatomegaly and abdominal ultrasound were performed.

Main Results:

• Hepatomegaly (51.6%) and elevated liver enzymes (SGOT 61.3%, SGPT 48.4%) were common.
• Hepatic dysfunction was present even in children without hepatomegaly.
• All liver function parameters normalized within 2-3 weeks after successful antibiotic therapy, indicating transient dysfunction.

Conclusions:

• Pediatric typhoid fever, particularly multidrug-resistant strains, frequently presents with transient hepatic dysfunction.
• Liver function abnormalities are common and can occur independently of hepatomegaly.
• Successful antibiotic treatment leads to the resolution of hepatic manifestations.